Claims Associate

2 weeks ago

Roseville, United States PMA Companies Full time
Back Account Claims Associate I -CA #4365 Multiple Locations + 2 more Apply Apply for this job now Apply Job Description:

In this position, you will investigate and maintain medical only and limited lost time workers‘ compensation claims. In this position you will determine liability, secure information and settles claims. Under close supervision and guidance, you will work within defined limits and authority on simple to medium complexity claims to manage your assigned caseload.



Responsibilities:



  • With supervision, you will evaluate claimant eligibility, communicate with attending physician and employer and injured worker
  • Work with both the claimant and their physician to medically manage the claim from initial medical requests to reviewing and evaluating on going medical information.
  • Work directly with employers to facilitate a return to work either on a Full-time or modified duty basis
  • Provide consistent customer service to both our customers and claimants through timely responses to all inquiries, telephone calls and e-mails while delivering on service commitments
  • Manage both new claims as well as open claims equally.
  • Demonstrate commitment to Company‘s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
Requirements:

  • High school diploma or equivalent
  • Knowledge of medical terminology and/or Workers Compensation a plus
  • License required or ability to obtain license within 90 days of employment in mandated states
  • The ability to multi-task and prioritize is needed; strong organization and time management skills are required
  • Demonstrated customer service skills are required
  • Strong verbal and written communication skills are required
  • Computer literate with good typing and computer skills (Microsoft Office) are required.
Locations Roseville Los Angeles

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